The purposes of this ethnographic study are to explore how chronic illness is experienced and managed by rural Hispanic and non-Hispanic older adults and their families, and to identify how the healthcare system and the community facilitates or inhibits the ability to manage chronic illness in an evolving managed care environment. The specific aims of the study are to: (1) describe how chronic illness is experienced by rural-dwelling older adults and their families, (2) describe how chronic illness is managed by the elders and their families, (3) explore the interactions of chronically ill older adults with the healthcare system and community, and (4) identify problems with healthcare services from the perspective of chronically ill rural older adults, their families, healthcare providers, and community members. An ethnographic research design will be employed to engage participants in culturally sensitive interactions to elicit rich descriptions of healthcare experiences and health-seeking behaviors. Data collection methods will include: semi-structured interviews, observations, photographs, and examination of cultural artifacts. Data analysis will involve ethnographic analysis of evolving categories, domains and themes. Sample size is estimated at 15-20 Hispanic and non-Hispanic (White) rural older adults, with an additional 15-20 family members, healthcare professionals, and community members. The significance of this study is to provide knowledge which contributes to nursing practice and healthcare policy impacting rural health services to improve the delivery of care for this culturally diverse population.